Prevalence of hepatotoxicity among HIV-infected patients in Ethiopia: a systematic review and meta-analysis

Ousman Mohammed; Ermiyas Alemayehu; Habtye Bisetegn; Mihret Tilahun; Alemu Gedefie; Endris Ebrahim; Mesfin Fiseha; Mogesie Necho; Temesgen Fiseha

doi:10.1186/s12879-022-07838-w

Prevalence of hepatotoxicity among HIV-infected patients in Ethiopia: a systematic review and meta-analysis

Ousman Mohammed
, Ermiyas Alemayehu
, Habtye Bisetegn
, Mihret Tilahun
, Alemu Gedefie
, Endris Ebrahim
, Mesfin Fiseha
, Mogesie Necho
, Temesgen Fiseha

Research output: Contribution to journal › Article › peer-review

10 Citations (Scopus)

Abstract

Background: Globally, the human immunodeficiency virus has been recognized as a major public health concern. The direct toxicity of antiretroviral medicines or their active metabolites causes liver cell destruction by different mechanisms, inducing immune-mediated inflammation, oxidative stress, and other mechanisms. On the other hand, the virus itself also produces hepatotoxicity. Therefore, this systematic review and meta-analysis aimed to assess the pooled prevalence of hepatotoxicity among HIV-infected patients in Ethiopia.

Methods: PubMed, Science Direct, Cochrane Library, Web of Science, and ResearchGate databases were used to find relevant articles. As well, various professional associations were searched to retrieve grey literature. The Newcastle–Ottawa Quality Assessment Scale was used to assess the quality of recruited studies. The data were extracted using Microsoft Excel, and the meta-analysis was carried out using STATA 14 software. I² and Cochran’s Q test were employed to assess the presence of heterogeneity between studies. A random effect model was used. The funnel plot and Egger’s statistics were used to assess publication bias. Moreover, subgroup analysis and sensitivity analysis were also done.

Results: The pooled prevalence of hepatotoxicity among HIV patients in Ethiopia was 25.45% (95% CI = 20.06–30.84%). There was high heterogeneity, with an I² value of 93.7%. Subgroup analysis by HAART status showed a higher pooled prevalence of hepatotoxicity among HIV patients taking HAART (23.63%) than among HAART naive patients (7.29%). In subgroup analysis, the pooled prevalence of hepatotoxicity among HIV/Tb co-infected and HIV mono-infected patients was 26.3% and 17.94%, respectively.

Conclusion: The current systematic review and meta-analysis showed a high prevalence of hepatotoxicity among HIV-infected patients. Therefore, regular monitoring of hepatotoxicity among HIV-infected patients is required in order to avoid liver damage and other complications.

Systematic review registration PROSPERO (2022:CRD42022334704).

Original language	English
Article number	826
Number of pages	14
Journal	BMC Infectious Diseases
Volume	22
Issue number	1
DOIs	https://doi.org/10.1186/s12879-022-07838-w
Publication status	Published - 9 Nov 2022
Externally published	Yes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Antiretroviral therapy
Ethiopia
Hepatotoxicity
HIV/AIDS
Liver enzyme elevation

Access to Document

10.1186/s12879-022-07838-wLicence: CC BY

Final published versionFinal published version, 2.48 MBLicence: CC BY

Cite this

@article{aa625174a2d242e992999c276dd3a74c,

title = "Prevalence of hepatotoxicity among HIV-infected patients in Ethiopia: a systematic review and meta-analysis",

abstract = "Background: Globally, the human immunodeficiency virus has been recognized as a major public health concern. The direct toxicity of antiretroviral medicines or their active metabolites causes liver cell destruction by different mechanisms, inducing immune-mediated inflammation, oxidative stress, and other mechanisms. On the other hand, the virus itself also produces hepatotoxicity. Therefore, this systematic review and meta-analysis aimed to assess the pooled prevalence of hepatotoxicity among HIV-infected patients in Ethiopia. Methods: PubMed, Science Direct, Cochrane Library, Web of Science, and ResearchGate databases were used to find relevant articles. As well, various professional associations were searched to retrieve grey literature. The Newcastle–Ottawa Quality Assessment Scale was used to assess the quality of recruited studies. The data were extracted using Microsoft Excel, and the meta-analysis was carried out using STATA 14 software. I2 and Cochran{\textquoteright}s Q test were employed to assess the presence of heterogeneity between studies. A random effect model was used. The funnel plot and Egger{\textquoteright}s statistics were used to assess publication bias. Moreover, subgroup analysis and sensitivity analysis were also done. Results: The pooled prevalence of hepatotoxicity among HIV patients in Ethiopia was 25.45\% (95\% CI = 20.06–30.84\%). There was high heterogeneity, with an I2 value of 93.7\%. Subgroup analysis by HAART status showed a higher pooled prevalence of hepatotoxicity among HIV patients taking HAART (23.63\%) than among HAART naive patients (7.29\%). In subgroup analysis, the pooled prevalence of hepatotoxicity among HIV/Tb co-infected and HIV mono-infected patients was 26.3\% and 17.94\%, respectively. Conclusion: The current systematic review and meta-analysis showed a high prevalence of hepatotoxicity among HIV-infected patients. Therefore, regular monitoring of hepatotoxicity among HIV-infected patients is required in order to avoid liver damage and other complications. Systematic review registration PROSPERO (2022:CRD42022334704).",

keywords = "Antiretroviral therapy, Ethiopia, Hepatotoxicity, HIV/AIDS, Liver enzyme elevation",

author = "Ousman Mohammed and Ermiyas Alemayehu and Habtye Bisetegn and Mihret Tilahun and Alemu Gedefie and Endris Ebrahim and Mesfin Fiseha and Mogesie Necho and Temesgen Fiseha",

year = "2022",

month = nov,

day = "9",

doi = "10.1186/s12879-022-07838-w",

language = "English",

volume = "22",

journal = "BMC Infectious Diseases",

issn = "1471-2334",

publisher = "BioMed Central Ltd.",

number = "1",

}

TY - JOUR

T1 - Prevalence of hepatotoxicity among HIV-infected patients in Ethiopia

T2 - a systematic review and meta-analysis

AU - Mohammed, Ousman

AU - Alemayehu, Ermiyas

AU - Bisetegn, Habtye

AU - Tilahun, Mihret

AU - Gedefie, Alemu

AU - Ebrahim, Endris

AU - Fiseha, Mesfin

AU - Necho, Mogesie

AU - Fiseha, Temesgen

PY - 2022/11/9

Y1 - 2022/11/9

N2 - Background: Globally, the human immunodeficiency virus has been recognized as a major public health concern. The direct toxicity of antiretroviral medicines or their active metabolites causes liver cell destruction by different mechanisms, inducing immune-mediated inflammation, oxidative stress, and other mechanisms. On the other hand, the virus itself also produces hepatotoxicity. Therefore, this systematic review and meta-analysis aimed to assess the pooled prevalence of hepatotoxicity among HIV-infected patients in Ethiopia. Methods: PubMed, Science Direct, Cochrane Library, Web of Science, and ResearchGate databases were used to find relevant articles. As well, various professional associations were searched to retrieve grey literature. The Newcastle–Ottawa Quality Assessment Scale was used to assess the quality of recruited studies. The data were extracted using Microsoft Excel, and the meta-analysis was carried out using STATA 14 software. I2 and Cochran’s Q test were employed to assess the presence of heterogeneity between studies. A random effect model was used. The funnel plot and Egger’s statistics were used to assess publication bias. Moreover, subgroup analysis and sensitivity analysis were also done. Results: The pooled prevalence of hepatotoxicity among HIV patients in Ethiopia was 25.45% (95% CI = 20.06–30.84%). There was high heterogeneity, with an I2 value of 93.7%. Subgroup analysis by HAART status showed a higher pooled prevalence of hepatotoxicity among HIV patients taking HAART (23.63%) than among HAART naive patients (7.29%). In subgroup analysis, the pooled prevalence of hepatotoxicity among HIV/Tb co-infected and HIV mono-infected patients was 26.3% and 17.94%, respectively. Conclusion: The current systematic review and meta-analysis showed a high prevalence of hepatotoxicity among HIV-infected patients. Therefore, regular monitoring of hepatotoxicity among HIV-infected patients is required in order to avoid liver damage and other complications. Systematic review registration PROSPERO (2022:CRD42022334704).

AB - Background: Globally, the human immunodeficiency virus has been recognized as a major public health concern. The direct toxicity of antiretroviral medicines or their active metabolites causes liver cell destruction by different mechanisms, inducing immune-mediated inflammation, oxidative stress, and other mechanisms. On the other hand, the virus itself also produces hepatotoxicity. Therefore, this systematic review and meta-analysis aimed to assess the pooled prevalence of hepatotoxicity among HIV-infected patients in Ethiopia. Methods: PubMed, Science Direct, Cochrane Library, Web of Science, and ResearchGate databases were used to find relevant articles. As well, various professional associations were searched to retrieve grey literature. The Newcastle–Ottawa Quality Assessment Scale was used to assess the quality of recruited studies. The data were extracted using Microsoft Excel, and the meta-analysis was carried out using STATA 14 software. I2 and Cochran’s Q test were employed to assess the presence of heterogeneity between studies. A random effect model was used. The funnel plot and Egger’s statistics were used to assess publication bias. Moreover, subgroup analysis and sensitivity analysis were also done. Results: The pooled prevalence of hepatotoxicity among HIV patients in Ethiopia was 25.45% (95% CI = 20.06–30.84%). There was high heterogeneity, with an I2 value of 93.7%. Subgroup analysis by HAART status showed a higher pooled prevalence of hepatotoxicity among HIV patients taking HAART (23.63%) than among HAART naive patients (7.29%). In subgroup analysis, the pooled prevalence of hepatotoxicity among HIV/Tb co-infected and HIV mono-infected patients was 26.3% and 17.94%, respectively. Conclusion: The current systematic review and meta-analysis showed a high prevalence of hepatotoxicity among HIV-infected patients. Therefore, regular monitoring of hepatotoxicity among HIV-infected patients is required in order to avoid liver damage and other complications. Systematic review registration PROSPERO (2022:CRD42022334704).

KW - Antiretroviral therapy

KW - Ethiopia

KW - Hepatotoxicity

KW - HIV/AIDS

KW - Liver enzyme elevation

UR - https://www.scopus.com/pages/publications/85141457148

U2 - 10.1186/s12879-022-07838-w

DO - 10.1186/s12879-022-07838-w

M3 - Article

C2 - 36352398

AN - SCOPUS:85141457148

SN - 1471-2334

VL - 22

JO - BMC Infectious Diseases

JF - BMC Infectious Diseases

IS - 1

M1 - 826

ER -

Prevalence of hepatotoxicity among HIV-infected patients in Ethiopia: a systematic review and meta-analysis

Abstract

UN SDGs

Keywords

Access to Document

Other files and links

Fingerprint

Cite this